Enhance Access To Health Care Research Articles

Acceptability of telemedicine for early surgical site infection diagnosis after cesarean delivery in rural Rwanda: a qualitative study

BackgroundTelemedicine interventions, while promising for enhancing healthcare access, require an evaluation of feasibility and acceptability to inform field implementation. This qualitative study explored the acceptability of a telemedicine intervention in which surgical incision photos taken by community health workers (CHWs) were sent to hospital-based general practitioners to diagnose surgical site infections (SSIs) following cesarean section in rural Rwanda. As the study timeline coincided with the beginning of the COVID-19 pandemic we additionally asked about their perceptions of telemedicine in this context .MethodsWe conducted qualitative, semi-structured in-depth interviews in Kinyarwanda among 26 individuals (14 women and 12 CHWs) who participated in the telemedicine intervention. The interviews were transcribed verbatim and translated into English. Thematic analysis was applied and parallel inductive coding was used to develop English and Kinyarwanda codebooks. These were consolidated into a master codebook for final coding.ResultsAll women and CHWs found the photo-based telemedicine program acceptable, though some concerns were raised. One woman voiced concerns about the reliability of photos in detecting SSIs compared to in-person visits. Women and CHWs reported perceived faster healing associated with the intervention, enhanced access to postoperative care from home, and cost savings as notable benefits of the telemedicine program. Trust in CHWs emerged as a critical factor for community acceptance. While one CHW expressed reservations about implementing the intervention during COVID-19, the majority of CHWs and patients indicated strong acceptance, with some even preferring it.ConclusionThese findings highlight the acceptance - from both caregivers and patients - of the photo-based telemedicine intervention in a resource-limited context, even amid crises like the COVID-19 pandemic. This acceptance was reinforced with recognized benefits, with trust in CHWs serving as a crucial factor. These insights can inform the development of telemedicine interventions in similar settings.

Bridging the Digital Divide: A Practical Roadmap for Deploying Medical Artificial Intelligence Technologies in Low-Resource Settings.

In recent decades, the integration of artificial intelligence (AI) into health care has revolutionized diagnostics, treatment customization, and delivery. In low-resource settings, AI offers significant potential to address health care disparities exacerbated by shortages of medical professionals and other resources. However, implementing AI effectively and responsibly in these settings requires careful consideration of context-specific needs and barriers to equitable care. This article explores the practical deployment of AI in low-resource environments through a review of existing literature and interviews with experts, ranging from health care providers and administrators to AI tool developers and government consultants. The authors highlight 4 critical areas for effective AI deployment: infrastructure requirements, deployment and data management, education and training, and responsible AI practices. By addressing these aspects, the proposed framework aims to guide sustainable AI integration, minimizing risk, and enhancing health care access in underserved regions.

Parents’ Cultural Practices and Infant Mortality in Mangu Local Government Area of Plateau State, Nigeria

Infant mortality remains a significant public health concern in Nigeria, with cultural practices playing a crucial role in child survival. This study examined parents’ cultural practices and infant mortality in Mangu Local Government Area of Plateau State, Nigeria. The study used a descriptive, cross-sectional survey research design. A sample size of 400 respondents was selected from the total population of 442,100 using the Tare Yamane formula. Questionnaires were distributed to 400 randomly selected participants across all the wards in Mangu LGA. Interviews were also conducted with six key informants to complement the data gathered from the questionnaires Responses from the questionnaires were analyzed using descriptive statistics of frequency counts and percentages. Qualitative data were analyzed while outlining the key point presented by the key informant. The study revealed that cultural practices, such as reliance on traditional herbs, beliefs in supernatural causes, and generational curses, significantly contribute to infant mortality in Mangu LGA by discouraging timely medical interventions. The study concludes that deep-rooted trust, affordability, and community influence sustain these practices, making it difficult for parents to fully embrace modern healthcare. The study recommended that enhancing healthcare access, educating communities on infant health, and collaborating with traditional leaders can bridge the gap between cultural practices and modern medical care, promoting timely and effective interventions.

Under nutrition among low-income Guatemalans

This study examines the dietary and health difficulties encountered by impoverished communities in Guatemala, with the goal of gaining a thorough understanding of the intricate elements that affect health outcomes in these marginalized people. The study used a mixed-methods approach, integrating quantitative analyses of secondary and primary data with qualitative insights obtained through interviews and focus group discussions. The research findings emphasize a substantial prevalence of moderate health problems among the communities under study, as seen by the concentration of health outcomes around a value of 70. The consumption of nutrients has been identified as a critical factor in determining health outcomes, since a lower intake is linked to inferior health. Positive associations were observed between socioeconomic level, access to healthcare services, and health outcomes. These findings add to the wider discussion on health inequalities and the factors that influence health in low-income environments. The study emphasizes the significance of focused interventions, advocating for dietary programs, poverty reduction initiatives, and enhanced healthcare access. It highlights the importance of empowering the community, encouraging their involvement, and adopting comprehensive strategies to tackle the complex issues faced by these communities.

Exploring health outcome disparities in African regional economics communities: a multilevel linear mixed-effect analysis

BackgroundIn African Regional Economic Communities (RECs), notable and enduring disparities exist in health outcomes. This study investigates the impact of macro-level characteristics of countries on health outcomes disparities within the African Regional Economic groupings. The study used panel data from the World Bank Development Indicators (WDI) and the Worldwide Governance Indicators (WGI), spanning 37 African countries, grouped into eight RECs between 2000 and 2019. We employed infant and under-five mortality rates and life expectancy at birth as indicators of health outcomes.MethodThe study used a multilevel linear (ML) mixed-effect approach to examine the influence of country-level factors on health outcome disparities within the eight African RECs recognized by the African Union.ResultsThe findings show that higher unemployment rates and HIV incidence exacerbate these disparities, while a growing elderly population and improved access to basic drinking water can mitigate them. Increased internet usage correlates with higher within-regional inequalities in child mortality rates but reduces disparities in life expectant at birth. Urbanization trends contribute to lower-intra-regional inequality in infant mortality rates and life expectancy at birth. Higher domestic government health expenditure as a share of general government spending is linked to reduced disparities in under-five and infant mortality rates. Still, it increases inequalities in life expectancy at birth within the regional groupings. Moreover, a higher proportion of the population below 15 years old and trade gains positively influence regional disparities in life expectancy. Conversely, DTP immunization coverage among children aged 12–23 months is associated with higher within-regional inequality in infant mortality rates.ConclusionsPolices aimed at reducing unemployment rates and HIV incidence should be prioritized. In addition, governments should invest in elderly care programs and infrastructure development for water supply. Efforts to promote internet access should be complemented by interventions to enhance child health and healthcare accessibility. Encouraging urban planning policies that prioritize developing healthcare infrastructure and facilitating healthcare access in urban areas is crucial. Furthermore, Governments should increase their health expenditure allocation in general government spending. Promoting strategies to enhance healthcare access and quality for specific demographics, alongside leveraging trade gains to invest in healthcare infrastructure and services, is imperative. Targeted interventions ensuring equitable access to immunization services should also be emphasized.

Analysis of study Global Burden of Disease in 2021: global, regional, and national burden of nutritional deficiency from 1990 to 2021.

Nutrient deficiency disorders (NDs) harm growth, causing economic losses. Addressing NDs is a global priority, yet recent data is limited. This study examines latest NDs data across 204 countries and 21 regions from 1990 to 2021. Data from the 2021 Global Burden of Disease (GBD) study were used to analyze NDs-related incidence, prevalence, deaths, and disability-adjusted life years (DALYs) at global, national, and regional levels. Joinpoint regression analysis was applied to evaluate temporal trends, with Estimated Annual Percentage Change (EAPC) assessing long-term patterns. In 2021, the global burden of NDs remained substantial, with a total of 1,845,246,558 cases with an ASPR of 23,858.99 cases per 100,000 individuals (95% UI: 23,445.77-24,320.82). The ASIR was 7,725.1 per 100,000 people (95% UI: 7,404.01-8,109.01), while the ASMR was 3.03 per 100,000 persons (95% UI: 2.69-3.4). Additionally, age-standardized DALYs rate was 657.62 per 100,000 individuals (95% UI: 489.93-869.58). Regionally, areas with low SDI exhibited the greatest ASPR, ASIR, ASDR, and age-standardized DALYs rates, whereas high SDI regions had the lowest rates. Although global NDs burden has declined from 1990 to 2021, regional and demographic disparities remain. Enhanced healthcare access in high-risk SDI regions is essential to further mitigate NDs's global impact.

Enhancing Healthcare Access Through Data Analytics and Visualizations: Bridging Gaps in Equity and Outcomes

Enhancing Healthcare Access Through Data Analytics and Visualizations: Bridging Gaps in Equity and Outcomes

Confirmatory validation of the transgender health care humanization scale

BackgroundDespite the critical importance of humanized healthcare for transgender individuals, no existing measures specifically assess care humanization for this population. The Transgender Health Care Humanization Scale (THcH Scale) was developed to address this gap, yet it initially lacked confirmatory validation. This study validates the Transgender THcH scale for evaluating healthcare providers’ sensitivity towards transgender patients.MethodsThis study involved 443 healthcare professionals and students from a public university and associated hospital. Participants were divided randomly into two groups for Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Using the Kaiser-Meyer-Olkin Measure of Sampling Adequacy and Bartlett’s Test of Sphericity, EFA confirmed data suitability for factor analysis. Factors were identified using parallel analysis with an oblique Promax rotation to allow for inter-factor correlations. The internal consistency of the factors was assessed using Cronbach’s alpha. CFA was performed using Maximum Likelihood estimation, with goodness-of-fit evaluated by multiple indices. The THcH Scale’s divergent validity was assessed through Spearman’s correlation analysis with the Duke University Religion Index (DUREL).ResultsExploratory and Confirmatory Factor Analyses confirmed the scale’s two-factor structure with excellent psychometric properties, including high internal consistency (Cronbach’s alpha > 0.8) and good fit indices (χ²/df = 1.74, CFI = 0.972, TLI = 0.964, GFI = 0.989, RMSEA = 0.069, SRMR = 0.043). Divergent validity was established through moderate correlations with the DUREL index.ConclusionsThe THcH scale is a reliable and valid tool for promoting sensitivity and awareness among healthcare professionals, thereby enhancing healthcare access and quality for the transgender population. Further research should expand its application to primary care and diverse populations and settings.

Out of Pocket Expenditure Among Patients Covered Under Voluntary Health Insurance for Kidney Replacement Therapy in a Tertiary Care Teaching Hospital in Coastal Karnataka

Background Chronic kidney disease (CKD) is a global health concern and is associated with high cost of care. This study aims to evaluate the out-of-pocket expenditure (OPE) among CKD patients covered by voluntary health insurance (VHI) for kidney replacement therapy (KRT) services and assess their knowledge and satisfaction with existing coverage. Materials and Methods Data were collected from 68 patients covered by 14 VHI schemes. Sociodemographic characteristics, morbidity details, and health insurance specifics were analyzed using SPSS software. Statistical tests, including Chi-square and Mann-Whitney U, were used to assess associations and median satisfaction scores. Results Significant differences were found between government and private health insurance companies regarding morbidity (X2=8.094, p=0.004) and annual family income (X2=5.057, p=0.03). Statistically significant variations (p < 0.001) were also observed in policy type, beneficiary type, annual premiums, coverage amounts, enrollment duration, and frequency of hospital admissions. OPE showed no significant difference. Satisfaction scores for reimbursement and affordability were high but not statistically significant. Many participants lacked awareness about aspects of their health insurance policy, regardless of the provider. Conclusion Despite VHI coverage, CKD patients undergoing KRT experience substantial financial burden. Improved patient education and policy transparency are essential to address gaps in coverage and alleviate financial strain. These findings underscore the need for policy reforms and patient-centered interventions to enhance healthcare access and affordability for CKD patients in India.

The Impact of Wearable Technology on Health Monitoring: A Data-Driven Analysis with Real-World Case Studies and Innovations

Wearable technology has revolutionised health monitoring with real-time data collection, personalised health insights, and enhanced healthcare access. A data-driven look at how wearable gadgets affect health outcomes in chronic illness management, fitness tracking, and preventive treatment. Real-world case studies show how wearable technology improves patient engagement and medical decision-making. AI-powered diagnostics and non-invasive biosensors are also examined as healthcare advancements. Data privacy, device accuracy, and user compliance remain issues despite their potential. This study emphasises the need for strong frameworks to address these issues and maximise wearable technology's health advantages

Forecasting cardiovascular disease risk and burden in China from 2020 to 2030: a simulation study based on a nationwide cohort

BackgroundCardiovascular disease (CVD) remains a significant public health challenge in China. This study aimed to project the burden of CVD from 2020 to 2030 using a nationwide cohort and to...

Comprehensive Review of Healthcare Systems and Their Evolving Structures

Physical assessment of healthcare organizations shows they are experiencing changes in response to the dynamic global healthcare needs, technologies, and political, economic, and social systems. This extensive literature review explores the various dimensions of the HC system, including governance and financing, the health workforce, and models of the service delivery systems. It seeks to look at the various issues confronting healthcare delivery systems across the developed and developing worlds with special reference to policies, technology, and human resources. The current paper offers insight into how healthcare systems are evolving to enhance healthcare access, quality, and efficiency from the case studies and additional literature. The review also outlines some emerging trends, such as value-based care, personalized medicine, and digital tools in health. The implications of the knowledge support the effectiveness of the overall system transformation to establish firm and fair healthcare for the actual people's needs.

The Trend of Tuberculosis Case Notification Rates from 1995 to 2022 by Country Income and World Health Organization Region.

Over the past 27 years, three major global TB control strategies have been implemented, and it is important at this stage to evaluate their impact on tuberculosis (TB) case notification rates (CNRs). This study, therefore, analyzed TB CNR trends from 1995 to 2022 across 208 countries and islands, using data from the WHO Global TB Programme database. Countries were classified by income level and population size based on World Bank criteria. The analysis revealed significant disparities in TB CNRs across income groups: Low-income, lower-middle-income, and upper-middle-income countries consistently reported higher CNRs compared to high-income countries. Regional analysis further demonstrated notable variations influenced by both economic and geographical factors. These findings reaffirm the strong link between TB and poverty, underscoring the need for a holistic approach to combat the disease. Efforts must extend beyond enhancing health care access and delivery to addressing the social determinants that drive TB transmission and progression.

Determinants of traditional birth attendant utilisation among reproductive age women in Ethiopia: a multilevel analysis of the 2019 Ethiopian Demographic and Health Survey

ObjectivesTo identify the determinants of traditional birth attendants’ utilisation among reproductive-age women in Ethiopia.DesignCross-sectional study design.SettingEthiopia.ParticipantsA total of 3979 weighted samples of reproductive-age women were included.Outcome measureTraditional birth attendant utilisation.ResultsThis...

Enhancing healthcare access and quality: PA prescribing in the United States.

Enhancing healthcare access and quality: PA prescribing in the United States.

Assessment of knowledge, perception, and readiness for telepharmacy-assisted pharmaceutical services among young pharmacists in rural Indonesia

BackgroundThe implementation of telepharmacy technology has expanded significantly, particularly during the COVID-19 pandemic, to ensure continuous pharmaceutical care services. This practice is vital in rural and underserved areas where access to healthcare is limited. ObjectiveThis study aims to assess the knowledge, perception, and readiness of young pharmacists in rural Indonesia towards telepharmacy-assisted pharmaceutical services. MethodsA cross-sectional study was conducted from January to July 2023 in rural areas of Java, Sumatra, and Kalimantan, Indonesia. A convenience sampling method was employed with the aim of recruiting 520 registered pharmacists under 35 years of age (23–34 years old). Data were collected using an online questionnaire adapted for the local context and analyzed using SPSS version 26.0. ResultsThe study achieved an 86.67 % response rate. Most participants were female (73.1 %) and aged between 26 and 30 years (53.8 %). Nearly all pharmacists (97.1 %) held a Pharm.D degree. The knowledge assessment showed high awareness of telepharmacy's importance and its role during the COVID-19 pandemic, with 96.15 % recognizing the need for a strong internet connection. Positive perception was noted, with 90.38 % agreeing that telepharmacy enhances medication access in rural areas. However, concerns about increased error rates and workload were highlighted. A substantial proportion of pharmacists expressed readiness for conducting drug counselling via video consultation (44.23 %) and showed a willingness to undergo relevant training (59.62 %). ConclusionYoung pharmacists in rural Indonesia demonstrate a good level of knowledge and generally positive perceptions about telepharmacy, with notable readiness among pharmacists with less than five years of experience. While there is notable willingness to engage in telepharmacy practices and training, addressing concerns about workload and data security through targeted support and training will be crucial for the successful implementation of telepharmacy, potentially enhancing healthcare access in rural areas.

Social innovation in access to healthcare: community-based health insurance among Senegalese migrants in Spain

BackgroundIn several European Union countries, undocumented migrants face significant barriers to accessing universal healthcare. In Spain, Royal Decree-Law 16/2012 introduced restrictions that limited undocumented migrants’ access to healthcare services, offering only emergency, maternal, and paediatric care. The implementation of this law created significant disparities in access to healthcare across regions. Although the law was later amended and some regions introduced alternative programs to restore access, disparities in healthcare access remain. This study aims to analyse the contribution of Community-based Health Insurance (CBHI), developed by migrant organisations, to improving healthcare access for Senegalese migrants in Spain.MethodsWe conducted 28 in-depth interviews and one discussion group across various Spanish localities between 2019 and 2022 to examine how CBHI influences healthcare access among Senegalese migrants. Using purposive sampling, we ensured diversity in participants’ administrative status, sociodemographic profiles, and employment situations. Grounded theory was employed to analyse the data, focusing on the social innovation and organizational dynamics of the tontines, as well as the role migrant organizations play in facilitating healthcare access through these solidarity-based financial mechanisms.ResultsThe findings show that CBHI has emerged as a socially innovative, collective response to unmet medical needs. Through the mobilization of community funds, Senegalese migrant organizations have filled gaps left by the public and private healthcare systems, offering a crucial alternative for those excluded from formal services. Our findings also highlight the rise of transnational healthcare trends, as community insurance funds are allocated not only for healthcare in Spain but also for return and care in Senegal. This dual focus demonstrates the importance of these grassroots microfinance initiatives in enhancing healthcare access for migrants.ConclusionsCBHI through tontines represents an essential community-led solution that enhances healthcare access for undocumented Senegalese migrants in Spain. Migrant organizations serve as key intermediaries, using solidarity-based microfinance models to bridge healthcare gaps left by restrictive policies. These initiatives demonstrate the capacity for grassroots innovation to address structural barriers to healthcare access in both destination and origin countries, providing a model for other migrant communities facing similar challenges.

The Impact of Telemedicine on Chronic Disease Management: A Post-Pandemic Analysis of Patient Outcomes and Accessibility

This study explores the impact of telemedicine on chronic disease management, focusing on patient outcomes and healthcare accessibility in the post-pandemic context. Using a qualitative research approach, the study examines how telemedicine has transformed the management of chronic conditions, especially for patients facing geographical or mobility barriers. Data were collected through in-depth interviews with patients, healthcare providers, and policy experts to gain insights into the experiences and challenges associated with telemedicine for chronic care. The findings reveal that telemedicine has improved patient accessibility to healthcare services, enabling consistent monitoring and timely interventions, which positively impact patient health outcomes. However, the study also identifies challenges, including technological barriers and limitations in patient-provider communication, that may affect care quality and patient satisfaction. Despite these issues, telemedicine is seen as a valuable supplement to traditional healthcare, enhancing healthcare access, especially for underserved populations. This research provides key insights for healthcare policymakers and practitioners in improving telemedicine practices, ensuring that they address accessibility gaps without compromising quality. The study concludes that, with strategic improvements, telemedicine holds significant potential to transform chronic disease management and make healthcare more equitable.

Determinants of underweight among returnee lactating mothers in Gedeb District, Southern Ethiopia: a case–control study

ObjectiveThis study aimed to assess the determinants of underweight among returnees lactating mothers in governmental health facilities of Gedeo zone, Southern Ethiopia.DesignCase–control study.SettingGedeb District governmental health facilities.ParticipantsA total of 264...

Interventions employed to address vaccine hesitancy among Black populations outside of African and Caribbean countries: a scoping review

BackgroundBlack people are disproportionately affected by structural and social determinants of health, resulting in greater risks of exposure to and deaths from COVID-19. Structural and social determinants of health feed vaccine hesitancy and worsen health disparities.ObjectiveThis scoping review explored interventions that have been employed to address vaccine hesitancy among Black population outside of African and Caribbean countries. This review provides several strategies for addressing this deep-rooted public health problem.MethodsThe scoping review followed the five-step framework outlined by Arksey and O’Malley. It complies with reporting guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Research studies that examined interventions utilized to promote vaccine confidence within Black populations living outside of African and Caribbean countries were reviewed.FindingsA total of 20 articles met the inclusion criteria for this study: 17 were quantitative studies and three were mixed-method studies. This scoping review highlighted six themes: educational advancement, messaging, multi-component approaches, outreach efforts, enhancing healthcare access, and healthcare provider leadership.ConclusionThe review identified effective interventions for addressing vaccine hesitancy among Black populations outside Africa and the Caribbean, emphasizing education, multidimensional approaches, and healthcare provider recommendations. It calls for more qualitative research and interventions in countries like Canada and the UK to enhance vaccine confidence and reduce mistrust.